Fatal Jarish-Herxheimer Reaction with Sudden Aneurysmal Dilatation and Complete Bronchial Occlusion Following Penicillin Therapy

Diefenbach, William C. L.

doi:10.1056/nejm194907212410303

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…Additionally, crude phage lysates often contained high levels of lipopolysaccharide. In sufficient quantities, lipopolysaccharide may lead to endotoxic shock and death in debilitated individuals ( Diefenbach, 1949 ). The generally poor efficacy of commercial phage preparations led to widespread criticism and disagreement about the effectiveness of phages in treating disease.…”

Section: Decline Of Phage Therapy In the Westmentioning

confidence: 99%

“…If the body is overwhelmed by a large and rapid release of ET following the death of bacterial cells, the patient may experience fever‐like symptoms and a worsening of the presenting disease ( Pound and May, 2005 ). This potentially fatal response ( Diefenbach, 1949 ), otherwise known as the Herxheimer reaction, could also occur with phage‐mediated lysis. While antibiotics diffuse from the site of administration and gradually lose potency, bacteriophages may further penetrate host tissues leading to uncontrolled liberation of ET.…”

Section: Critical Appraisal Of Phage Biocontrolmentioning

confidence: 99%

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Bacteriophage biocontrol in animals and meat products

Atterbury

2009

Microbial Biotechnology

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SummarySince their discovery almost a century ago, bacterial viruses (bacteriophages or ‘phages’) have been used to prevent and treat a multitude of bacterial infections (phage therapy: PT). In addition, they have been the basis for many advances in genetics and biochemistry. Phage therapy was performed on human subjects in the United States, Europe and Asia in the few decades following their discovery. However, Western countries largely abandoned PT in favour of antibiotics in the 1940s. The relatively recent renaissance of PT in the West can be attributed partly to the increasing prevalence of antibiotic resistance in human and animal pathogens. However, the stringent controls on human trials now required in the United States and Europe have led to a greater number of domestic animal and agricultural applications as an alternative to PT in man. This trend is set to continue, at least in the short term, with recent approval from the Food and Drug Administration allowing commercial phage treatments to be used in human food in the USA. Nevertheless, despite these significant milestones and the growing number of successful PT trials, significant obstacles remain to their widespread use in animals, food and ultimately medicine in many parts of the world. This review will provide a brief overview of the history of PT in the West and will summarize some of the key findings of phage biocontrol studies in animals and meat products.

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Section: Decline Of Phage Therapy In the Westmentioning

confidence: 99%

Section: Critical Appraisal Of Phage Biocontrolmentioning

confidence: 99%

Bacteriophage biocontrol in animals and meat products

Atterbury

2009

Microbial Biotechnology

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“…Indeed the literature has several reports of fatal reactions among patients with syphilis in which too strong a JarischHerxheimer reaction was induced. [93][94][95] Our treatment protocol encourages physician and patient to work together to adjust levels of olmesartan and antibiotics in order to continually achieve a tolerable level of immunopathology.…”

Section: Potential Severity Of Immunopathologymentioning

confidence: 99%

Immunostimulation in the era of the metagenome

Proal

Albert

Blaney³

et al. 2011

Cell Mol Immunol

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Microbes are increasingly being implicated in autoimmune disease. This calls for a re-evaluation of how these chronic inflammatory illnesses are routinely treated. The standard of care for autoimmune disease remains the use of medications that slow the immune response, while treatments aimed at eradicating microbes seek the exact opposite-stimulation of the innate immune response. Immunostimulation is complicated by a cascade of sequelae, including exacerbated inflammation, which occurs in response to microbial death. Over the past 8 years, we have collaborated with American and international clinical professionals to research a model-based treatment for inflammatory disease. This intervention, designed to stimulate the innate immune response, has required a reevaluation of disease progression and amelioration. Paramount is the inherent conflict between palliation and microbicidal efficacy. Increased microbicidal activity was experienced as immunopathology-a temporary worsening of symptoms. Further studies are needed, but they will require careful planning to manage this immunopathology.

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“…The possibility of adverse reactions, such as those of Herxheimer (Butterly and Fishman, 1952;Diefenbach, 1949;Whorton and Denham, 1951) and the " therapeutic paradox" (Mohr and Hahn, 1952;Porter, 1948), necessitated caution in the use of penicillin, but these untoward reactions rarely have been encountered in patients with cardiovascular syphilis (Tucker and Farmer, 1947;Edeiken andothers, 1949, 1950;others, 1946, 1949;Flaum and Thomas, 1949;Sinclaire and Webster, 1951 syphilis in the venereal disease control program of the Chicago Board of Health are here reported. The series comprises 578 patients in whom cardiovascular syphilis was diagnosed before 1947.…”

Section: British Jo Urnal Of Venereal Diseasesmentioning

confidence: 99%